| Due to increasing prevalence rate of diabetes mellitus(DM) and elongation of patiens, diabetic nephropathy(DN) already had become the common complication of DM. In America, DN is the first cause in telophase renal failure. Because of the rising living standard and aging social, the rising ratio of DN in telophase renal failure would occur in china. Therefore, DN would be a important problem that the doctor must be faced in 21 century. At present, non-dialysis, dialysis and renal or renal-pancreas transplantation are the chief treatments of DN. But dialysis and organ transplantation cannot be popular, as non-dialysis is still very important. The satisfactory effect of traditional Chinese medicine made itself become important therapeutic method.Part One Research backgroundIt is believed that congential defect, improper diet, overstrain and emotional maladjustment are essential etiological factors of DN in Traditional Chinese Medicine(TCM), as deficiency of ben (deficiency ofyin, yang, qi, blood, lung, spleen and kidney) with excess syndrome of biao (retention of dampness and blood stasis) is the basic pathogenesis. The basic pathologic process is injury of yin and qi, then extent that yang-qi is involved, deficiency in spleen and kidney, obstruction of blood stasis, retention of dampness, stagnation of toxic turbid in human body. In various phase, the focal point of pathogenesis is different. The most of scholars lay particular emphasis on deficiency of spleen and kidney with retention of dampness and blood stasis, especially dampness and blood stasis lying in the whole process of DN.The effect of DN with TCM treatment and its superiority had been confirmed, making up the deficiency of modern medicine as controlling the disease progress, improving symptom, Adjusting metabolism, decreasing blood viscosity, and so on. Theeffect of TCM had been demonstrated by experiment investigation from pharmac-odynamics to pathomorphology.Based on lots of research and advisor's clinic experience, Tangduqing granules (include membranous milkvetch root, rhubarb, sanchi, korean epimedium herb) was decided to treat later-phase DN, as its principle replenishing qi, restorating the function of spleen, invigorating kidney, removing dampness and promoting blood circulation to remove blood stasis. In this topic, anima models of later-phase DN were created to study the effect of Tangduqing granules and its possible mechanisms, regulating expression of transforming growth factor P i and activity of PAI-1, as evidence provided for the clinic use. At present, it was much research of TCM on DN earlier period or metaphase and little on later period, less on animals experiment. Much of research was unable to clarify its action mechanism, especially absence of advanced index.It is thinked in modern medicine that the main pathologic change of DN involve hypertrophy of glomerulus and renal tubule, Increased thickness of basement membrane, extracellular matrix stack of glomerular mesangium and sclerosis tubule-interstitial. These are related to the unclear mechanism, as disorder of glycometabolism, change of kidney hemodynamics, genetic background, comprehensive effect of various kinds of growth factor, celluar medium and chemokine induced by hyperglycemia. It is thinked much highlier, the action on glomerulosclerosis caused by accumulation and degradation of ECM. If cut out the action, it would be great significance for glomerulosclerosis and development of DN. The action of membranous milkvetch root, rhubarb and its extract was confirmed in lots of research on regulation of TGF- 3 i and PAI-1.Part Two Experimental ResearchObjective Based on lots of research on document and advisor's clinic experience, it was thinked that the important pathogenesis of later-phase diabetic nephropathy(DN) was deficiency of spleen and kidney , as well as retention of dampness and blood stasis. Then Tangduqing granules(include membranous milkvetch root, rhubarb, sanchi, korean epimedium herb) was decided to treat later-phase DN, as i...
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